High blood pressure, also known as hypertension, affects millions of people worldwide. This health concern, if left unmanaged, can lead to more serious conditions such as heart disease, stroke and kidney failure.
- The CDC states that 48.1% of adults in the USA have hypertension, so it’s a common problem. And in 2021, hypertension was a primary or contributing cause of 691,095 deaths.
- The WHO estimates 1.28 billion adults aged 30–79 years worldwide have hypertension, while 46% of them don’t even know they have the condition.
- The HHS states four out of five hypertension patients are recommended by a doctor to take prescription medication for it.
(Yes, I know that these are all corrupted and captured institutions but stats like these from them are reasonably trustworthy…except for these being an example of creeping medicalization as covered below.)
Blood pressure is important because problems here can lead to problems many other places across the body.
(One area of particular interest due to blood vessel damage to many of our customers is erectile dysfunction which was covered here.)
Of course, medication is not our primary focus here except to get the lay of the land. Hypertension is a result of lifestyle, and thus can be taken care of in a majority of cases with lifestyle interventions only. But I’m not a doctor, so this is not medical advice but instead is my philosophical health advice.
In follow-up articles to this one, I’ll specifically cover herbs that both lower and raise blood pressure. But first, it’s important to cover the basics.
What is Blood Pressure?
In each cycle of the heart’s pumping action we experience two kinds of pressures – systolic and diastolic. (Though I must state for the record that the heart is much more than a pump, that the whole circulatory system moves blood even before the heart is formed in an embryo. Much more on this topic inside of Powered By Nature.)
When your heart muscle contracts, it propels a surge of blood into your arteries, pushing against the vessel walls. This phase, the heartbeat, is when the pressure is at its highest. This top number on your blood pressure reading is the systolic blood pressure. For a healthy adult, it typically ranges from 90 to 120 mmHg.
In contrast, the diastolic blood pressure, the lower number, represents the pressure in your arteries when your heart is at rest between beats. It’s the moment of the lowest pressure, which allows the heart to receive its supply of blood and oxygen. For a healthy individual, the diastolic pressure usually falls between 60 and 80 mmHg.
Blood pressure is measured in millimeters of mercury, abbreviated as mmHg. This unit of measure has historical roots, tracing back to the first accurate pressure gauges which used a column of mercury to measure pressure. This unit of measure is still used today even with modern digital blood pressure devices with no mercury involved.
In a typical blood pressure reading, you’ll see two numbers written for example as as ‘120/80 mmHg’. The first number represents the systolic pressure, and the second denotes diastolic pressure.
What is Hypertension?
Prior to 2017, the universally accepted threshold for hypertension was a blood pressure reading of 140/90 mmHg.
However, this approach began to change with research suggesting that even slightly elevated blood pressure levels below this threshold could increase the risk of heart disease and stroke. The American Heart Association and the American College of Cardiology decided to update the hypertension guidelines in 2017. The new guidelines split hypertension into Stage 1 and Stage 2, providing what they said was a nuanced approach that allows for earlier intervention.
Under the new guidelines, a blood pressure reading of 130-139/80-89 mmHg, previously considered as “prehypertension,” is now classified as Stage 1 hypertension.
On the other hand, blood pressure readings of 140/90 mmHg or higher are classified as Stage 2 hypertension.
In the conventional medical community, lifestyle interventions such as diet and exercise are generally recommended at Stage 1, and medications at stage 2.
However, we must beware of the creeping medicalization this also indicates. This is whereby non-disease conditions come to be viewed and treated as medical problems, which is why almost half the adult human race is said to have this medical problem. This will almost assuredly lead to an increase in unnecessary medication prescriptions. After all, the associations that recommended these guideline changes are funded by pharmaceutical companies which sell those drugs. (For more on this topic see #65 and #66 in my Medical Monopoly Musings.)
The reclassification, though intended to encourage earlier intervention, effectively labeled a substantial percentage of adults as ‘hypertensive’ overnight, many of whom had blood pressure readings previously classified as ‘normal’ or ‘prehypertension.’
Overall, hypertension is more common in men than in women.
Conventional Drug Treatment
Conventional treatment for hypertension typically includes prescription medications such as diuretics, ACE inhibitors, and calcium channel blockers. This chart includes many different types and names of hypertensive medications.
Each class works in a different way. More on these will be covered in the second part of this blood pressure blog series, in that herbs can have similar biochemical actions. These effects may be helpful, but also come at the cost of unwanted side effects. For example:
- Diuretics – These help kidneys eliminate sodium and water to lower blood pressure. Side effects may include frequent urination, electrolyte imbalances, and potential kidney damage with long-term use. Some may experience dizziness, increased thirst, and in rare cases, erection problems in men.
- Beta-Blockers – They work by reducing the heart rate and the heart’s workload. Fatigue, cold hands and feet, slow heartbeat, and reduced exercise capacity are possible side effects. They can also exacerbate symptoms of asthma.
- ACE inhibitors – These drugs relax and widen your blood vessels. They can cause dry cough, skin rashes, loss of taste, and in rare cases, kidney damage. Some people might experience a rapid swelling of deep skin layers and tissues (angioedema).
- Calcium channel blockers – These medications disrupt the movement of calcium through the blood vessel walls and heart cells, helping to relax and widen arteries. Potential side effects include palpitations, swollen ankles, constipation, headaches, and dizziness.
- Angiotensin II receptor blockers (ARBs) – They function similarly to ACE inhibitors but typically cause fewer side effects. They can cause occasional dizziness, but the main concern is the rare possibility of kidney damage.
- Alpha-Blockers – These drugs reduce nerve impulses to blood vessels. Potential side effects include fast heart rate, dizziness upon standing up (orthostatic hypotension), and in men, problems with ejaculation.
As we see here there’s a wide range of side effects. That’s not to say that these drugs aren’t useful or even necessary in some cases, but that lower level interventions are less risky.
Conventional Lifestyle and Diet Modifications for Hypertension
These are the commonly recognized modifications that your doctor would recommend to help keep your blood pressure in check:
- Healthy Eating – Adopting a diet that’s rich in fruits, vegetables, whole grains, and lean proteins can have a significant impact on blood pressure. The DASH diet (Dietary Approaches to Stop Hypertension) is a well-researched dietary plan that’s been shown to lower blood pressure. It emphasizes low sodium intake and promotes foods rich in nutrients like potassium, calcium, and magnesium.
- Reducing Sodium Intake – High salt intake is a common contributor to hypertension. The American Heart Association recommends limiting sodium to less than 1,500 mg per day. This requires being a vigilant label-reader since many processed foods contain high amounts of sodium.
- Physical Activity – Regular exercise strengthens the heart, enabling it to pump blood more efficiently and thus lowering the pressure in your arteries. Aim for at least 30 minutes of moderate-intensity exercise, like brisk walking, swimming, or cycling, most days of the week.
- Maintaining a Healthy Weight – Weight loss and maintaining a healthy weight can have a dramatic impact on blood pressure. Even losing a small amount of weight if you’re overweight can help reduce your blood pressure. Obesity is strongly correlated with hypertension.
- Limiting Alcohol and Quitting Smoking – Excessive alcohol can raise your blood pressure, while smoking introduces chemicals that can damage your blood vessels, leading to hypertension. Limit alcohol to moderate levels (up to one drink a day for women and two for men) and seek help to quit smoking if you’re a smoker.
- Managing Stress – Chronic stress can contribute to hypertension. Incorporating stress management techniques such as mindfulness, meditation, yoga, or deep breathing can help manage blood pressure.
Overall, not some bad advice. However, as you might imagine, not everyone agrees with everything listed here.
Unconventional Lifestyle and Diet Modifications for Hypertension
Some research indicates that only a minority of the population is salt-sensitive, experiencing a rise in blood pressure with increased salt intake. For these individuals, cutting back on salt may be beneficial. However, for the rest, excessively low salt intake might actually pose health risks, including increased heart disease mortality!
Diets like the Mediterranean diet, rich in monounsaturated fats from olive oil and omega-3 fatty acids from fatty fish, are commonly recognized to be heart-healthy. Yet even the high-fat, low-carb ketogenic diet has shown promising results in lowering blood pressure in some studies.
While fat has often been painted as the villain in cardiovascular health, emerging research suggests that sugar may be a more significant culprit. Excessive intake of refined sugars, particularly fructose, has been linked to increased risk of hypertension.
Not just the cardio mentioned earlier, but some evidence shows proper strength training is useful for hypertension. A July 2023 meta-analysis published in the BMJ found that isometric exercise (that is pushing against resistance without movement) yielded the largest lowering in blood pressure compared to aerobics, strength training, HIIT and more.)
More research shows that targeted vitamin and mineral supplementation can play a large role in hypertension, with some notables including potassium, magnesium, calcium, vitamin D, coenzyme Q10, folate and others.
While managing stress was mentioned earlier, a deeper look at the emotional connection behind blood pressure is often neglected. Are the patterns of stoically suppressing anger and anxiety connected? Some research finds it so.
In researching for this article I came across this fascinating 1995 case study about processing decades old trauma:
“This report presents the case of a 49-year-old woman who had been treated unsuccessfully for 6 years for longstanding severe and refractory essential hypertension. Although she reported no extraordinary stress or distress, her disclosure of a 3-decade-old rape and the experiencing of previously repressed and unconfided emotions related to it were followed by a dramatic and sustained improvement in her blood pressure. This case suggests that repressed emotions, which patients cannot report, may contribute substantially to the development of essential hypertension, even when they are related to decades-old events. More attention to repressed emotions, and better means of studying them, are needed before the mystery of the links between psychological factors and essential hypertension is unraveled.”
Emotional suppression is common across so much of humanity and it tends to be stronger in men due to cultural upbringing. Perhaps this is one reason that hypertension is more common in men than women.
In a nutshell, hypertension, a pervasive concern affecting millions of people globally, presents a complex health scenario that calls for intricate understanding and individualized intervention strategies.
Lifestyle modifications undeniably play a crucial role in managing hypertension, not to mention avoiding it in the first place. Conventional recommendations like the DASH diet, regular physical activity, and stress management techniques form the cornerstone of non-pharmaceutical interventions.
Yet, emerging unconventional perspectives — from rethinking the role of sodium and embracing fat-friendly diets to considering the potential benefits of intermittent fasting and examining the impact of repressed emotions — offer intriguing alternatives.
As we journey deeper into this fascinating terrain of blood pressure management, we will explore the intriguing role that herbs can play both in raising and lowering blood pressure. Stay tuned for an insightful dive into how certain herbs can affect your blood pressure, offering potential natural adjuncts to any hypertension management plan. Read the next article here: Herbs that Lower Blood Pressure.